the world's leading medical assistance company
TRANSCRIPT
the world’s leading medical assistance company
“Your Passport to Quality Health”
Overview
• Program purpose• SOS London/tricare functional
organizational structure• Routine care • Urgent / emergent care• Authorization process• Air evacuation
EUCOM
CENTCOM
•Expansive area•Difficult to reach locations•Many command structures with multiple and varied missions•Complex inter-governmental relationships
Program Purpose
30oW 17
oE
Atlantic Ocean
Arctic Ocean
Indian OceanAtlantic Ocean
CENTCOM
EUCOM
42oE30
oW 17
oE
Atlantic Ocean
Arctic Ocean
Indian OceanAtlantic Ocean
CENTCOM
EUCOM
42oE
• As of 1st July 2001 As of 1st August 2002– Egypt - Djibouti– Ethiopia - Eritrea– Kenya– Kuwait– Pakistan– Saudi Arabia
• As of 1st June 2002 As of 1st October 2002– Jordan - Kazakhstan (Almaty)– Oman - Kyrgyzstan (Bishkek)– Qatar - Turkmenistan (Ashgabat)– UAE - Uzbekistan (Tashkent)
CENTCOM
EUCOM and outside of Continental United States Start Date:
1 SEPTEMBER 03
the world’s leading medical assistance company
“Your Passport to Quality Health”
Global Remote Program
GOALS
•Provide Cashless Access to Care
•Ensure Quality of providers and facilities
•Manage Costs
International SOS
International SOS
International SOS
– Worlds leading medical assistance company– More than 20 years experience– Offices in 39 countries– Over 200 full time physicians– Medical referral network in more than 150
countries
International SOS
Provides active duty and their families assigned to remote locations the following:
– “Credentialed” provider network– PCM concept of operations/advice line, self care– 24/7 call center– Referral/Utilization Management– Emergency air evacuation if military assets are not
available/feasible– Cashless and claimless services
International SOSFacts & Figures
3,000 professionals 24 call centers Offices in 43 countries 300 full-time medical staff Over 40 in-house languages
Network of credentialed medical providers Handles thousands of cases every day Perform one evacuation every hour Provide healthcare to 180,000 each year through
international SOS clinics
Hospital Evaluation Criteria• Physical plant• Hygiene• Medical staff• Nursing staff• Diagnostic capabilities• Surgical and intensive care capabilities• Emergency services• Administrative organization• Financial considerations
Physician Evaluation Criteria • Minimum criteria:
– graduate of an accredited medical school– licensed
• Office location and hygiene• Experience treating foreign patients• English language proficiency• Hospital affiliation • Overseas training• Local reputation• Availability
TRICARE Program
Service Delivery Receipt of new request
– By e-mail– By fax – By phone
•From POC•From Provider•From Member•From TEO
Routine Care• For Active Duty (AD)and Active Duty
Family Members(ADFM)
• Primary Care Providers– Mainly seen by HU / MTF for GP– Dental and OB-GYN– Wellness Program investigations
• Specialist care Providers– Referral from HU / MTF– Notification to SOS through local POC– Orthopedist, Ophthalmologist and
Dermatologist
Urgent / Emergent Care
Urgent / Emergent Care
• For AD / ADFM and TDY/TAD personnel
• Urgent Care– Requiring medical intervention within 24
hours
• Emergent Care – Requiring medical intervention within 4
hours
• Hospitalization and Patient movement
Authorization Process
Medical Authorization
• Member’s eligibility– Verification through DEERS– Confirmation from POC/TEO on patient’s
status
• Medical information– Patient’s problem identified– Services required
• Referral Letter for Specialist care provided
Medical Authorization
• Approval– Medical Department to review
request and provides approval within the parameters of the TRICARE program
• Guarantee Letter (GOP)– Issue Guarantee Letter to provider,
copy to POC as appropriate
Dental Care
AD Dental Authorization
• Member’s eligibility – Active duty (permanent party)– Network dentist– Cashless claimless
• Dental information– Patient’s problem identified– Services required
• GOP (guaranteed letter of payment AD only)– For current/approved treatment
– “Other” treatment must be approved prior
ADFM Dental Authorization
– Referral services only– Same network dentist– Family Member must file claim
with UCCI (United Concordia Companies inc.)
– No GOP
Evacuation Process
Medical (Air) Evacuation
• Emergency Only
• SOS Responsibilities– Contact Theatre Patient Movement
Requirements Center (TPMRC) all EVAC’s
– Contact TRICARE Europe (TEO) update on patient’s status
SOS Dedicated Air Ambulance
Locations
30oW
Europe: Europe: Baden Baden (Lear 55)Baden Baden (Lear 55)
Africa:Africa: Johannesburg (Falcon 10, Lear 25 & Beechcraft Johannesburg (Falcon 10, Lear 25 & Beechcraft C90)C90)
Gaborone (Cessna 402)Gaborone (Cessna 402)
Windhoek – (Cessna Citation II)Windhoek – (Cessna Citation II)
CIS: CIS: Moscow (Hawker 125-1A)Moscow (Hawker 125-1A)
Far East:Far East: Singapore (Falcon 200)Singapore (Falcon 200)
Beijing (Hawker 800XP)Beijing (Hawker 800XP)
Australasia:Australasia: Port Moresby – (Citation II)Port Moresby – (Citation II)
SOS Dedicated Air Ambulances
30oW 17
oE
5oS, 68°E
Indian Ocean
Atlantic Ocean
Pacific Ocean
42oE
Your Role
Review local provider list
Provide International SOS with a preferred provider list (you will be contacted)
the world’s leading medical assistance company
“Your Passport to Quality Health”
Your Role as a:•TRICARE POC •Healthcare/Health Unit Provider
Educate military and family members about the TRICARE -International SOS Global Remote program
Coordinate w/TRICARE Europe
the world’s leading medical assistance company
“Your Passport to Quality Health”
Your Role as a:•TRICARE POC •Healthcare Provider
EUCOM and outside of Continental United States Start Date:
1 SEPTEMBER 03
the world’s leading medical assistance company
“Your Passport to Quality Health”
Global Remote Program
the world’s leading medical assistance company
“Your Passport to Quality Health”